Associations between neighbourhood fast-food environments and hypertension in Canadian adults.

Abstract

ObjectivesHypertension is a leading cause of cardiovascular disease and premature death. Neighbourhoods characterized by a high proportion of fast-food outlets may contribute to hypertension in residents; however, limited research has explored these associations. The objectives of this study were to assess associations between neighbourhood fast-food environments, measured and self-reported hypertension.
 ApproachWe used data from 10,700 adults who participated in six cycles of the Canadian Health Measures Survey (CHMS). Measured hypertension was defined as having an average systolic blood pressure (BP) of ≥140, a diastolic BP ≥90 mm Hg or being on BP lowering medication. Participants were also asked if they had been diagnosed with high BP or if they take BP lowering medication (i.e., self-reported hypertension). We characterized the fast-food environment of each participant’s neighbourhood using the Canadian Food Environment Dataset (Can-FED). We considered the proportion of fast-food outlets relative to fast-food outlets and full-service restaurants as a continuous variable.
 ResultsThe mean proportion of fast-food outlets was 23.3% (SD 26.8%). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of measured hypertension in the full sample (OR=1.17, 95% CI 1.05 to 1.31) and in sex-specific models (women: OR=1.14, 95% CI 1.01 to 1.29; and men: OR=1.21, 95% CI 1.03 to 1.43). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of self-reported hypertension in the full sample (OR=1.13, 95% CI 1.02 to 1.24); however, associations were inconclusive in sex-specific models (women: OR=1.11, 95% CI 0.99 to 1.26; and men: OR=1.14, 95% CI 0.99 to 1.33).
 ConclusionBy linking neighbourhood food environment measures that were created from an administrative data source (the Statistics Canada Business Register) to individual-level data from the CHMS, we were able to demonstrate that reducing the proportion of fast-food outlets in neighbourhoods may reduce rates of hypertension and support individually targeted interventions.

Assessment of the Retail Food Environment Using Integrated GIS and Modified Measures in Wuhan, China

“…To determine whether the food served by each food outlet is healthy or unhealthy, we categorize Chinese retail food outlets into the following categories: chain supermarkets, convenience stores, fruit and vegetable markets, fast-food outlets, full-service restaurants, and specialty food stores by referring to the classification standard from the North American Industry Classification System (NAICS) [6]. In total, 6 retail food outlet types with 67 subclasses were identified.…”

“…For example, people who reside in an area with a high availability of ultra-processed food and an absence of fruit and vegetables are more likely to become overweight [4]. Neighborhoods characterized by a growing number or a high proportion of fast-food outlets may contribute to type 2 diabetes mellitus (T2DM) [5] and hypertension [6] in residents. Access to full-service restaurants was found to be significantly associated with a lower prevalence of diabetes [7].…”

“…They concentrated on the RFE neighborhood disparities [8] [9], the associations between RFE and diet-related outcomes [4] [5] [6] [10], food environment assessment methods [11] [12] and secondary data validity [9] [13] [14] [15] [16] [17]. These practical studies primarily from developed countries such as Canada [6] [11] [13], the United States [5] [17] [18], the United Kingdom [19] [20], and Spain [21], whereas developing countries contributed relatively limited experience and knowledge of RFE. There are significant disparities in dietary behaviors and food environments between countries with diverse cultural backgrounds, particularly in food culture.…”